Understanding Healthcare Labor Unrest in Three Words: Overworked, Understaffed, Underpaid

Pharmacy workers at Walgreens are walking off the job as labor unrest continues to rock the healthcare sector.

If you're tracking recent labor unrest in the United States these days, be forewarned that it could trigger a bout of vertigo.

Sometimes it seems like the whole country is on strike, with major walkouts seen in the auto industry, entertainment, and of course, healthcare.

Healthcare workers' grievances are pretty much the same: overworked, understaffed, underpaid.

The recently completed three-day walkout by more than 75,000 Kaiser Permanente workers—reportedly the largest healthcare sector strike in U.S. history—is technically over, but the issues that prompted the walkout, essentially staffing and compensation, have not been resolved.

The Coalition of Kaiser Permanente Unions this week gave the mega-healthcare system a three-week deadline to negotiate a settlement or risk a weeklong walkout starting on Nov. 1.

And, you might want to call your local Walgreens before you schlep over there for your meds. They might not be open. That's because frazzled, overworked pharmacy staff at some of the retailer's stores in several states walked out on Monday after complaining of harsh working conditions. The walkout is expected to last through Wednesday.

To its credit, Walgreens has acknowledged the stressors on its pharmacy workers and the sacrifices they've made.

"Our pharmacy teams work tirelessly to serve our communities—from administering life-saving vaccines, to helping patients receive prescriptions and health screenings—especially this time of year, during which we see some of the highest rates of respiratory illnesses and seasonal vaccinations," the company says today in prepared remarks to HealthLeaders.

"The last few years have required an unprecedented effort from our team members, and we share their pride in this work—while recognizing it has been a very challenging time. We also understand the immense pressures felt across the U.S. in retail pharmacy right now."

"We are engaged and listening to the concerns raised by some of our team members. We are committed to ensuring that our entire pharmacy team has the support and resources necessary to continue to provide the best care to our patients while taking care of their own well-being. We are making significant investments in pharmacist wages and hiring bonuses to attract/retain talent," the company says.

The Walgreens labor unrest comes on the heels of similar unrest at rival CVS Health, where late last month pharmacists in the Kansas City area—complaining of chronic understaffing and demanding overtime pay—walked off the job, prompting the closure of two dozen stores in the region.

"It's like running a McDonald's with just one person," one pharmacist told The Kansas City Star.

Another CVS pharmacist told The Star that CVS relies on an " 'arbitrary algorithm' to determine how many technician hours each pharmacy deserves per week."

Like Walgreens, CVS appears to have conceded its errors. In an internal memo to employees CVS Chief Pharmacy Officer Prem Shah apologized and admitted that "we haven't addressed these concerns in the region more quickly."

"With the currently unprecedented demand for vaccinations from our patients in mind, we are taking a series of actions effective immediately," Shah told employees. He says the company has pledged to provide "additional resources" to stores, hiring more workers, and easing the workload on pharmacists.  

CVS issued a statement saying "we're committed to providing access to consistent, safe, high-quality health care to the patients and communities we serve and are working with our pharmacists to directly address any concerns they may have."

"We're focused on developing a sustainable, scalable action plan to support both our pharmacists and our customers, that can be put in place in markets where support may be needed so we can continue delivering the high-quality care our patients depend on," the company says.

The CVS pharmacists' action garnered the support of the American Pharmacists Association (APhA), which noted that "pharmacists who find themselves in situations where the welfare of others is in question should always pause, evaluate the situation, and take the steps necessary to ensure safe, optimal patient care."

APhA also warned that the overworked, understaffed, underpaid conditions pharmacy workers endure are also a common complaint across the healthcare sector.

"The issues that lead to suboptimal healthcare working environments are complex and are not unique to pharmacies," APhA says. "We see similar situations in physicians' offices, hospitals, and other practice settings. Our health care system needs change which leads to supporting the patient–provider (including the pharmacist provider) relationship."

The California Pharmacists Association was blunt, blaming CVS for a "massive prescription backlogs of its own making, in large part due to aggressive patient-steering tactics driven by its Pharmacy Benefit Manager company, CVS Caremark."

"Due to these practices, patients are increasingly being denied access to other community and independent pharmacies where their pharmacy needs could be met," CPhA says. "This cherry-picking of patients away from other pharmacies, coupled with persistent understaffing at its own pharmacies, along with unreasonable workloads, has caused the untenable situation that its pharmacists and patients face today."

What makes the pharmacists' walkout from the nation's two biggest drug chains particularly notable is that these pharmacy workers are not unionized. It would be safe to say that the typical pharmacist is hardly a labor radical, so this grassroots and desperate action on their own is as remarkable as it is difficult to coordinate.

But when nonunion workers feel compelled to conduct an organized protest, that's a signal that the dissatisfaction runs deep and wide and should not be ignored.